Losing Anthem

Frequently Asked Questions

According to Anthem Blue Cross, “Today, planning and pricing for ACA-compliant health plans has become increasingly difficult due to shrinking individual market as well as continual changes in federal operations, rules and guidance.”

Next year, Anthem will only offer plans in three regions of Northern California only, which will include Redding, Santa Clara County, and Stockton/Modesto. If you are not in the following regions, your Anthem Blue Cross plan will end in December 31, 2017.

If you are not on a grandfathered plan (effective after March 23, 2010) or live in one of three Northern California regions, including Redding, Santa Clara County, and Stockton/Modesto, your Anthem Blue Cross plan will end in December 31, 2017.

No, but you should still understand your options. In 2018, your plan will automatically migrate to the lowest cost plan within the same metal tier as your current plan.

For example, if you are currently enrolled in a Bronze plan with Anthem, you will automatically be migrated to the cheapest Bronze plan available in 2018 with another carrier. IMPORTANT: Covered California will not necessarily migrate your plan to an equivalent plan type. Meaning, that you could be migrated to an HMO if you are on a PPO or EPO.

No, you are in no way obligated to keep the plan that you are migrated in. At BenefitPackages we will be here every step of the way to ensure that you get the best coverage for you and your family based on your specific healthcare needs.

IMPORTANT: Your coverage will be automatically terminated and you will not be migrated to another carrier. Current Anthem Blue Cross members that purchased directly will need to find another carrier during open enrollment in November to prevent coverage gaps.

On the exchange, plans are standardized. Off the exchange offer a “mirrored” metal tier plan that duplicates the same plan on the exchange. Carriers can vary benefits for non-mirrored off exchange plans.

Yes, Enhanced Silver Plans are available through the exchange for those with incomes between 150% & 250% of the Federal Poverty Level (FPL). The biggest Cost Sharing Reductions (CSR’s) are for the Enhance Silver 94 which offers $4 office visit copays with a $75 deductible and a $1,000 maximum out of pocket. On the other hand, the Platinum Plan doesn’t have a deductible, it does require you to pay 10% for certain services, (known as coinsurance) up to $4,000 per calendar year max out of pocket, afterwards the carrier pays 100%

The first question is whether it makes sense for us to put you through the exchange or directly to the carrier. We can help see if you qualify for Advanced Premium Tax Credits (APTC’s) to immediately lower your premium. We encourage our clients to keep us updated quarterly if their income changes by 10% as we can update your income on your behalf ; if it decreases we can increase your premium assistance, hence lowering your premium and if it increases we’ll lower your premium assistance to avoid a yearend tax liability. Our Agency can also help you see what plans have your doctors as Participating providers & your prescriptions as part of the carrier’s formulary.

BenefitPackages has been in business for more than 25 years. Our friendly licensed agents have helped thousands of people in California attain coverage that works for them. We take pride in helping people get the coverage they need by helping them save time and money.

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Questions? Comments? Give us a call now at 1-800-356-3615 or contact us!

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